ISSN:
1471-0528
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
Forty-one patients with a diagnosis of possible hydatidiform mole were studied by HCG, oestrogen and pregnanediol determinations performed on 24-hour collections of urine. The results were compared with those obtained in a control series involving 5000 HCG analyses, 679 oestrogen analyses and 1080 pregnanediol analyses performed over the relevant period of gestation in single pregnancies which produced surviving infants. Of the 17 patients who were shown to have a hydatidiform mole, 8 (47 per cent) had high HCG levels, 5 (29 per cent) had oestrogen levels below the first percentile for the control series and 5 of 13 patients had low pregnanediol levels (38 per cent). Five of the nine patients with molar pregnancies associated with normal HCG excretion had oestrogen excretion below the first percentile and one of the remaining four with normal oestrogen values had non-pregnancy levels of pregnanediol. Thus the diagnosis of an abnormal pregnancy could be made in 14 of the 17 molar pregnancies studied (82 per cent). Two of the three exceptions had a fetus co-existent with the mole. There were no viable pregnancies when the oestrogen and pregnanediol values were below the first percentile. Oestrogen and/or pregnanediol values in the range consistent with multiple pregnancy were found in four patients with molar pregnancies. In the molar pregnancies there was a correlation between the levels of HCG and the levels of oestrogens and pregnanediol excreted. After evacuation of the mole, the levels of oestrogens and pregnanediol remained elevated for up to three weeks in approximately half of the patients, whereas the HCG levels fell immediately. These findings support the view that in molar pregnancies, levels of oestrogens above 300 μg. per 24 hours and of pregnanediol above 10 mg. per 24 hours are derived mainly from the stimulation of theca lutein cysts in the ovaries.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1111/j.1471-0528.1970.tb03542.x
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